Contribution of county-level socioeconomic indicators to racial or ethnic differences in neonatal anthropometry in the USA: a prospective cohort study
Introduction Racial and ethnic differences in fetal growth and birth size in the USA have not been adequately explained by individual-level socioeconomic status (SES) factors. We explored whether differences may be partially explained by county-level indicators of SES.Methods We linked participant z...
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BMJ Publishing Group
2024-12-01
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| author | Zhen Chen Fasil Tekola-Ayele William A Grobman Marion Ouidir Pauline Mendola Jessica L Gleason Calvin Lambert Kathryn A Wagner Roger Newman Katherine L Grantz |
| author_facet | Zhen Chen Fasil Tekola-Ayele William A Grobman Marion Ouidir Pauline Mendola Jessica L Gleason Calvin Lambert Kathryn A Wagner Roger Newman Katherine L Grantz |
| author_sort | Zhen Chen |
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| description | Introduction Racial and ethnic differences in fetal growth and birth size in the USA have not been adequately explained by individual-level socioeconomic status (SES) factors. We explored whether differences may be partially explained by county-level indicators of SES.Methods We linked participant zip codes from the National Institute of Child Health and Human Development Fetal Growth Studies (2009–2013; n=1614) to county-level US census data to calculate a neighbourhood deprivation index, education isolation index and two indices of segregation: racial isolation and evenness. Using causal mediation methods, we evaluated the extent to which racial/ethnic differences in neonatal anthropometrics could be eliminated in a hypothetical setting where everyone lived in counties with high resource availability and racial/ethnic integration.Results Setting racial evenness to levels consistent with the highest diversity eliminated 79.9% of the difference in birth weight between non-Hispanic White and non-Hispanic Black and all the difference (106.3%) in birth weight between Hispanic and non-Hispanic White individuals. Setting racial evenness, racial isolation and education isolation to levels consistent with higher diversity and education was also associated with similar reductions in differences for other anthropometric measures.Conclusions Our findings suggest that, in a hypothetical scenario where everyone lived in counties with low deprivation or segregation, race/ethnic differences in neonatal anthropometry may substantially decrease or be eliminated. Our results also highlight the importance of considering community-level and structural factors in analyses of race/ethnic health disparities. |
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| institution | Kabale University |
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| language | English |
| publishDate | 2024-12-01 |
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| spelling | doaj-art-18071bf5a8c6422fafcf901aa380629a2024-12-17T16:55:09ZengBMJ Publishing GroupBMJ Public Health2753-42942024-12-012210.1136/bmjph-2024-001014Contribution of county-level socioeconomic indicators to racial or ethnic differences in neonatal anthropometry in the USA: a prospective cohort studyZhen Chen0Fasil Tekola-Ayele1William A Grobman2Marion Ouidir3Pauline Mendola4Jessica L Gleason5Calvin Lambert6Kathryn A Wagner7Roger Newman8Katherine L Grantz9Aff1 0000 0004 1803 6191grid.488530.2State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer InstituteSun Yat-sen University Cancer Center 510060 Guangzhou People’s Republic of ChinaEpidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USADepartment of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA1 IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Inserm, CNRS, Université Grenoble Alpes joint research center, Grenoble, France1Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland, USAEpidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USADepartment of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York, USAEpidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USADepartment of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina, USAEpidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USAIntroduction Racial and ethnic differences in fetal growth and birth size in the USA have not been adequately explained by individual-level socioeconomic status (SES) factors. We explored whether differences may be partially explained by county-level indicators of SES.Methods We linked participant zip codes from the National Institute of Child Health and Human Development Fetal Growth Studies (2009–2013; n=1614) to county-level US census data to calculate a neighbourhood deprivation index, education isolation index and two indices of segregation: racial isolation and evenness. Using causal mediation methods, we evaluated the extent to which racial/ethnic differences in neonatal anthropometrics could be eliminated in a hypothetical setting where everyone lived in counties with high resource availability and racial/ethnic integration.Results Setting racial evenness to levels consistent with the highest diversity eliminated 79.9% of the difference in birth weight between non-Hispanic White and non-Hispanic Black and all the difference (106.3%) in birth weight between Hispanic and non-Hispanic White individuals. Setting racial evenness, racial isolation and education isolation to levels consistent with higher diversity and education was also associated with similar reductions in differences for other anthropometric measures.Conclusions Our findings suggest that, in a hypothetical scenario where everyone lived in counties with low deprivation or segregation, race/ethnic differences in neonatal anthropometry may substantially decrease or be eliminated. Our results also highlight the importance of considering community-level and structural factors in analyses of race/ethnic health disparities.https://bmjpublichealth.bmj.com/content/2/2/e001014.full |
| spellingShingle | Zhen Chen Fasil Tekola-Ayele William A Grobman Marion Ouidir Pauline Mendola Jessica L Gleason Calvin Lambert Kathryn A Wagner Roger Newman Katherine L Grantz Contribution of county-level socioeconomic indicators to racial or ethnic differences in neonatal anthropometry in the USA: a prospective cohort study BMJ Public Health |
| title | Contribution of county-level socioeconomic indicators to racial or ethnic differences in neonatal anthropometry in the USA: a prospective cohort study |
| title_full | Contribution of county-level socioeconomic indicators to racial or ethnic differences in neonatal anthropometry in the USA: a prospective cohort study |
| title_fullStr | Contribution of county-level socioeconomic indicators to racial or ethnic differences in neonatal anthropometry in the USA: a prospective cohort study |
| title_full_unstemmed | Contribution of county-level socioeconomic indicators to racial or ethnic differences in neonatal anthropometry in the USA: a prospective cohort study |
| title_short | Contribution of county-level socioeconomic indicators to racial or ethnic differences in neonatal anthropometry in the USA: a prospective cohort study |
| title_sort | contribution of county level socioeconomic indicators to racial or ethnic differences in neonatal anthropometry in the usa a prospective cohort study |
| url | https://bmjpublichealth.bmj.com/content/2/2/e001014.full |
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